Societal Costs Associated With Pulmonary Arterial Hypertension Subgroups: A Study Utilizing Linked National...

Area of Science:

• Cardiology
• Public Health
• Health Economics

Background:

• Pulmonary arterial hypertension (PAH) is a complex condition with various subtypes, including idiopathic/hereditary PAH (IPAH/HPAH), and those associated with connective tissue disease (APAH-CTD) and congenital heart disease (APAH-CHD).
• Societal costs associated with PAH, both before and after diagnosis, are not well-characterized across its different subgroups.

Purpose of the Study:

• To estimate and compare the societal costs in a national PAH cohort, stratified by subgroup, during the 5 years preceding and 5 years following diagnosis.
• To compare these costs against a matched control group to understand the economic burden of PAH.

Main Methods:

• Utilized Swedish national databases to link patient data and estimate societal costs.
• Included incident PAH patients diagnosed between 2008-2019 and matched them 1:5 with a control group based on age, sex, and geography.
• Analyzed pre- and post-diagnosis costs, identifying main cost drivers for both patient and control groups.

Main Results:

• Pre-diagnosis, societal costs were substantially higher in all PAH subgroups compared to controls (2.9-4.3 times).
• Post-diagnosis, costs further increased significantly in PAH groups (1.6-3.1 times) while decreasing in controls.
• Post-diagnosis, healthcare costs (including drugs and inpatient/outpatient care) became the primary driver for PAH patients, accounting for a large proportion of direct costs, whereas hospitalizations dominated control group costs.

Conclusions:

• PAH imposes a significant societal economic burden, with costs escalating dramatically after diagnosis.
• APAH-CHD exhibited the highest relative societal costs pre-diagnosis, while IPAH/HPAH incurred the highest overall societal costs post-diagnosis.
• The findings highlight the substantial economic impact of PAH, emphasizing the need for cost-effective management strategies and support systems.